Wednesday, February 3, 2010

Childcare Class & Pediatrician Interview

Well, this is shaping up to be a busy week.

The hubby & I went to the childcare part of the class at the hospital last night. I'm still liking the tone of the classes and the instructors for the most part, but skittish of delivering there because of their pediatric team and the high epidural & c-section rates. Still, we will be finishing the childbirth education series at this hospital, even if I deliver elsewhere [we already paid for it, and I don't have time for the Bradley class I just found out existed nearby a week ago, and am too poor and cramped for time for Hypnobabies as well]. One thing I liked was that she went into detail on all of the typical newborn procedures, how & why they're done, and how to opt out or ask to delay certain things like the HepB vaccine . With feeding, she explained why breastfeeding was best, even short term, and about some of the things that pressured women into giving it up early [not surprisingly, returning to work, lack of support, & discomfort with nursing in public are big problems].  She also explained that circumcision was an elective procedure with no medical benefit, and even noted that most of the reasons supporting it had been debunked and disproved. Most of the class, of course, was basic newborn care, with pictures of some birth defects and other things and discussion of what is and isn't normal, and when to call the doctor - pretty basic stuff, but good information.

After the class, we went upstairs to tour the L&D unit and see a room - it's nice and pretty, but there is a lot of focus and money being spent on c-section related care, and it makes me hesitant because I wonder if a small town hospital really needs not only a separate operating room, but it's own recovery area and 1/4 of available rooms set up for post-op mothers. Also, the nurse didn't really give a lot of information on things, and seemed sort of irritated that we'd ask questions [they didn't seem busy, so it's not like that], and I found out that I couldn't get copies of pre-admission paperwork and consent forms in advance - they only do that for scheduled inductions & cesareans.

This morning, I got up bright and early and braved the lovely icy roads to interview another pediatrician. Long story short, I really, really, like her. The office is about 35 minutes away, but they do have a satellite office for weekend and urgent care much closer to the house. One thing I immediately liked is that they have separate waiting rooms, and separate exam rooms, for sick & well baby care, each with their own bathroom & changing facilities. Of the offices that even bother to separate them, most here have shared bathrooms and several just have chairs on different sides of the same area - this office even has 3 closed in rooms in the "sick" waiting area for patients with flu or highly contagious diseases.

The pediatrician herself gave me the tour, and took lots of time to answer my questions. She seemed very current on her vaccine knowledge, and we even discussed how Merck had stopped making the separate MMR vaccines, but it should be available again sometime in 2011. She said all vaccinations would be my choice, and that she would have no problem giving them one at a time and on a delayed schedule if that's what we decided. She also offered to do titer tests before vaccinating and giving boosters, especially if we delay. When I asked if she was used to caring for intact boys, she said that approximately 1/3 of her male patients were uncircumcised, and that she totally agreed with and supported our decision not to have him circumcised at birth. Again, she seems knowledgeable because she mentioned that if it needed to be done later, she would refer him to a urologist that would do it under anesthesia, but that problems were rare as long as the foreskin wasn't retracted or "messed with" by parents or care providers. She also told me that one of their pediatric nurses is a lactation consultant and that the other doctor in the practice specializes in breastfeeding & feeding problems, and offered for her to come out and check on my after the birth to be sure he was eating well, as well as encouraging me to call the office if there were any breastfeeding issues, rather than giving up or supplementing if that wasn't what I wanted to do. I'm glad I did ask around and didn't just settle for the closest office or the first name of out the phone book, because I feel so much more comfortable now.

On the way home, I toured the L&D floor at the other hospital [the one I'm considering switching to]. The hospital itself is smaller and older, but I like it because it is less institutional feeling. The nurse that showed me around took her time and explained standard procedures, as well as which things were optional or dependent on the physician. She said that the pre-admit and consent forms the had to be filled out within 3 days of admission, but that they had no problem sending home blank forms to review, and I could just fill it out and bring it in when I went into labor. The rooms themselves are not as fancy as the other hospital, but have plenty of room, and are actually set up in a way that gives you more privacy [ie, the tub and bed are blocked from view of the hallway]. She said they have had women labor in the in-room tubs, which or pretty big, or I can bring my birth pool, and they do have an underwater doppler for monitoring, if my midwife OKs that instead of the 20 minute strips with the belts. It just seemed a lot more laid back, and more focused on normal birth rather than strict procedures and expectations of surgery and complications, so I think it will be a more comfortable and less stressful place to give birth. I had a surgery at this same hospital back in April, and the staff there was wonderful then.

I'm going to talk to the midwife tomorrow, and assuming everything is good there, I'll definitely be making the switch. I did a little research online on the woman I'll be seeing in the morning, and everything looks good so far. A few women on the local parenting board see her for well-woman care, and 3 delivered with her, and they all said she was good, and very friendly towards natural birth and "crunchiness" in general. I also found out she previously worked as a midwife in the Atlanta area and was highly recommended there, as well as being one of the few waterbirth providers in that area for a long time. I'm looking at a little more out of pocket expenses with my insurance, but it should totally be worth it to have someone that's on the same page as me regarding birth and parenting.

2 comments:

  1. Wow! You are so lucky that hospitals like that exist where you are. They sound wonderfully supportive of a mother-centered birth! Labor and delivery is an amazing experience and even more so when you feel comfortable and supported.

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  2. This all sounds amazing! I would LOVE to have a ped like that. I'm so happy that you've found some better options. Can't wait to hear how the midwife visit goes!

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